Appointment Punctuality

1 Introduction

1.1 Policy statement

On occasion, patients attending appointments at Woodbrook Medical Centre will be late due to circumstances beyond their control. This document provides direction for the management of patients who fail to attend appointments punctually and is to be read in conjunction with the organisation’s Did Not Attend (DNA) Policy.

1.2 Status

The organisation will aim to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have regarding the individual protected characteristics of those to whom it applies.

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment. Furthermore, this document applies to all employees of the
organisation and other individuals performing functions in relation to the organisation such as agency workers, locums and contractors.

2 Policy

2.1 Patient responsibility

The NHS Constitution explains that patients should “keep appointments or cancel within reasonable time. Receiving treatment within the maximum waiting times may be compromised unless you do”. It is courtesy and expectation that patients inform this organisation as soon as possible if they are aware they will be late for an appointment.

Sometimes, patients arrive and simply take a seat in the waiting room assuming that there is no need to ‘book in’ upon arrival. To avoid any inconvenience for all, a self-check-in poster is available here to remind patients to use the self-check-in screen upon arrival.

2.2 Management of late arrivals

To adhere to the appointment schedule and to ensure all patients receive an excellent level of service, late arrivals are to be managed as follows:

    • Less than 10 minutes late – staff will:

        • Mark the patient as having arrived, advising them that the clinician may already be seeing the next patient

        • Explain that the patient will be seen after the clinician has finished with their current patient

        • If appropriate, remind the patient of the importance of attending appointments on time

    • More than 10 minutes late – staff will advise the patient that they have missed their appointment and offer the following as appropriate:

        • Offer the patient an appointment later during that session or that day (if an appointment is available)

        • Discuss the patient with the clinician and, if in agreement, and the patient is willing to wait, advise that they will be seen at the end of that session. The patient should be made aware that this may be some time.

        • Should the above option not be possible, the patient should rebook for another appointment

    • It should be noted that it is at the discretion of the clinician whether the patient is seen or not; there may be a valid reason for being late and each patient will advise staff accordingly. Ideally, clinicians are to be informed of any late arrivals via a screen message.

2.3 Management of waiting patients

Should staff note a patient has been waiting for more than 20 minutes, they should apologise to the patient, explaining the reason(s) for the delay. In the case of an administrative error, the administration team should advise the clinician of this and confirm the patient did not arrive
late for their appointment. Every effort should then be made to ensure the patient is seen in sequential order rather than being offered a later appointment.

If this situation occurs on a regular basis, then the management will consider conducting an audit with additional training being a consideration.

Should any patient have waited for more than 20 minutes then this should be investigated. Sometimes it may be that the patient has forgotten to check-in or that the reception team has failed to book the patient on the system as having arrived. The organisation displays a ‘Sorry to keep you waiting’ poster in all waiting areas on the TV Screens.

2.4 Recording of information

Administrative staff are to annotate the outcome of the discussion with the clinician regarding those patients who are more than 10 minutes late. Additionally, all staff are to ensure the appropriate SNOMED CT ID 401278005 is used to enable searches to be carried out accurately
and to monitor patients who are consistently late for appointments with clinicians.

2.5 Patient awareness

If a patient is late and the appointment is cancelled, then this is to be classified as a “Did not attend” as the appointment could not be reused. The patient may still expect to be seen at a later date, causing longer waiting times for all patients. To assist with patient understanding of the DNA problem, the following posters are available:

For further detailed information, see the organisation’s Did Not Attend (DNA) Policy.

2.6 Clinic lateness

The organisation is fully committed to running to schedule and, should this not be the case, patients will be advised at the earliest opportunity as to the reasons why and the expected duration of the delay. Reasons for delay may be, but are not limited to:

    • Medical emergencies

    • Complex routine appointments overrunning

    • Delay in staff arriving due to external factors beyond their control

    • Administrative error by a patient or staff member

In all cases, reception staff must advise patients accordingly.

Occasionally a patient may suggest that they want to make a complaint following an overrunning clinic. Should they wish to do so, then the Complaints Procedure should be referred to.